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The cardiac assessment is one of the core examinations performed by almost every physician whenever encountering a patient. Disorders of the cardiac system are among the most common reasons for hospital admission, with conditions ranging…

The heart beats rhythmically in a sequence called the cardiac cycle—a rapid coordination of contraction (systole) and relaxation (diastole).

Electrical signals—sent from the sinoatrial (SA) node in the right atrial wall to the atrioventricular (AV) node between the right atrium and right ventricle—cause both atria to simultaneously contract. When the signal reaches the AV node, it pauses for approximately a tenth of a second, allowing the atria to contract and empty blood into the ventricles before they contract. The electrical impulses are then conducted by the bundle of His and propagated to the left and right bundle branches. The signal is then conducted by Purkinje fibers in the ventricular walls, inducing ventricular contraction and pumping blood out of the heart. During diastole (relaxation), the heart fills with blood, and the cycle is repeated.…

Cells with similar structure and function are grouped into tissues. A group of tissues with a specialized function is called an organ. There are four main types of tissue in vertebrates: epithelial, connective, muscle, and nervous.

Epithelial tissue consists of thin sheets of cells and includes the skin and the linings of internal organs and body cavities. Epithelial cells are tightly packed, providing a barrier against injury, infection, and water loss. Epithelial tissue can be a single layer called simple epithelium, or multiple layers called stratified epithelium. In stratified epithelium, such as the skin, the outer cells—which are subject to damage—are replaced through the division of cells underneath. Epithelial cells have a variety of shapes, including squamous (flattened), cuboid, and columnar. Some epithelial tissues absorb or secrete substances, such as the lining of the intestines. Connective tissue is composed of cells within an extracellular matrix and includes loose connective tissue, fibrous connective tissue, adipose (fat) tissue, cartilage, bone, and blood. Although the characteristics of connective tissue vary greatly, their general function is to support and attach multiple tissues. For example, tendons are made of fibrous connective tissue and attach muscle to bone. Blood transports oxygen, nutrients and waste produ…

The parasympathetic nervous system is one of the two major divisions of the autonomic nervous system. This parasympathetic system is responsible for regulating many unconscious functions, such as heart rate and digestion. It is composed of neurons located in both the brain and the peripheral nervous system that send their axons to target muscles, organs, and glands.

Activation of the parasympathetic system tends to have a relaxing effect on the body, promoting functions that replenish resources and restore homeostasis. It is therefore sometimes referred to as the “rest and digest” system. The parasympathetic system predominates during calm times when it is safe to devote resources to basic “housekeeping” functions without a threat of attack or harm. The parasympathetic nervous system can be activated by various parts of the brain, including the hypothalamus. Preganglionic neurons in the brainstem and sacral part of the spinal cord first send their axons out to ganglia—clusters of neuronal cell bodies—in the peripheral nervous system. These ganglia contain the connections between pre- and postganglionic neurons and are located near the organs or glands that they control. From here, postganglionic neurons send their axons onto target tissues—generally smooth muscle, cardiac muscle, or glands. Typic…

Abdominal pain is a frequent presenting concern in both the emergency department and the office setting. Acute abdominal pain is defined as pain lasting less than seven days, while an acute abdomen refers to …

The nervous system is the collection of specialized cells responsible for maintaining an organism’s internal environment and coordinating the interaction of an organism with the external world—from the control of essential functions such as heart rate and breathing to the movement needed to escape danger.

The vertebrate nervous system is divided into two major parts: the central nervous system (CNS) and the peripheral nervous system (PNS). The CNS includes the brain, spinal cord, and retina—the sensory tissue of the visual system. The PNS contains the sensory receptor cells for all of the other sensory systems—such as the touch receptors in the skin—as well as the nerves that carry information between the CNS and the rest of the body. Additionally, part of both the CNS and PNS contribute to the autonomic nervous system (also known as the visceral motor system). The autonomic nervous system controls smooth muscles, cardiac muscles, and glands that govern involuntary actions, such as digestion. The vertebrate brain is primarily divided into the cerebrum, cerebellum, and brainstem. The cerebrum is the largest, most anterior part of the brain that is divided into left and right hemispheres. Each hemisphere is further divided into four lobes: frontal, parietal, occipital, and temporal. The outermost layer of the cerebrum is called…

The anterior shoulder dislocation is one of the most common joint dislocations seen in emergency settings. In anterior shoulder dislocation, the humeral head is displaced out of the glenohumeral joint in front of the scapular glenoid,…

A tension pneumothorax is a life-threatening situation in which excess air is introduced into the pleural space surrounding the lung, either through trauma to the chest cavity or as a spontaneous leak of air from the lung itself. Air…

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